Provider Demographics
NPI:1942702303
Name:WHITMAN, NATALIE (PCA)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:WHITMAN
Suffix:
Gender:F
Credentials:PCA
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:D
Other - Last Name:SAMPLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2933 STATE ROUTE 34 SOUTH
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526
Mailing Address - Country:US
Mailing Address - Phone:304-807-3304
Mailing Address - Fax:
Practice Address - Street 1:2933 STATE ROUTE 34 SOUTH
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526
Practice Address - Country:US
Practice Address - Phone:304-807-3304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
G23810020101OtherPROVIDER ID